RSS Feedhttps://10.40.239.128/blogs/rss-feed/Blog RSS Feeden{E3261A40-2C48-4E80-8659-09297BC34E40}https://10.40.239.128/blogs/2015/07/informed-family-planning/Informed Family PlanningLooking back at the greatest public health achievements of the 20th century, the Centers for Disease Control and Prevention (CDC) put family planning in the top ten for significantly improving the health of women, infants and children. Even though much progress has been made, about 50 percent of pregnancies in the United States are still unintended, and one in five unintended pregnancies are among teens.&nbsp;
<p>Methods and availability of birth control have changed over the years, ranging from fish bladder condoms in 3000 B.C. to the first rubber condom in 1838. Today, there are many different contraception options, but availability, religious and cultural barriers, as well as myths and fears associated with birth control may prevent people from using birth control. There is no one right contraceptive method. Individuals need to first understand their options, and then choose a birth control method that will work best for them. The following criteria should be taken into consideration when choosing a birth control method:&nbsp;
</p>
<p><strong>Effectiveness:</strong> How well can the method prevent a pregnancy? This is usually calculated as the percentage of women becoming pregnant with the method in a year. Different quotes are often explained by &ldquo;typical&rdquo; and &ldquo;perfect&rdquo; use.&nbsp;
</p>
<p><strong>Safety:</strong> What side effects can be expected and how dangerous are they? Are there any other benefits of the method apart from preventing pregnancy? The World Health Organization developed medical eligibility criteria for each birth control method including fertility awareness methods in order to grade the safety of a method in certain conditions.&nbsp;
</p>
<p><strong>Availability:</strong> How expensive is the method? Where can I get it? Is it easy to access? How long does it last?&nbsp;
</p>
<p><strong>Compliance:</strong> Is the individual able to consistently follow a birth control method&rsquo;s directions for use? For example, how good is she at taking a pill every day at the same time, using the patch weekly, or remembering to check her temperature? How good is her partner at withdrawal? How consistently do she and her partner use condoms?&nbsp;
</p>
<p><strong>Other factors to consider:</strong> Age, life style, number of children, reversibility of method, preference for non-hormonal methods, protection against sexually transmitted diseases, visibility.&nbsp;</p>
<p><strong>Combined Oral Contriceptive with Estrogen/Progesterone (COC)</strong>&nbsp;</p>
<p>&bull;<strong>Forms:</strong> Oral contraceptive pill, patch or ring. The pill can come in different strengths and combinations with different progesterones.&nbsp;
</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method ranges between 1 and 9 percent, depending on perfect or typical use.&nbsp;</p>
<p>&bull;<strong>Side Effects:</strong> Certain contraindications, risks of deep vein thrombosis.&nbsp;
</p>
<p>&bull;<strong>Other Benefits:</strong> Very regular periods, a reduction in pain and flow of periods, and a reduction in premenstrual syndrome symptoms, endometriosis symptoms, polycystic ovary syndrome and acne. A reduction in ovarian and endometrial cancer with long-term usage.&nbsp;</p>
<p>&bull;<strong>Availability:</strong> The pill is the cheapest of the three forms.&nbsp;
</p>
<p>&bull;<strong>Reversibility:</strong> Return to fertility begins immediately after stopping use.&nbsp;
</p>
<p><strong>Progesterone-Only Pill (POP)</strong>&nbsp;</p>
<p>&bull;<strong>Use:</strong> This pill must be taken at the same time each day and is often used during lactation with no effect on milk supply.&nbsp;
</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method ranges between 1 and 13 percent (no significant differences in view of used progesterone).&nbsp;
</p>
<p>&bull;<strong>Side Effects:</strong> Irregular bleeding and spotting. Fewer side effects and contraindications than with estrogen/progesterone pill.&nbsp;
</p>
<p><strong>Long-Acting Progesterone-Only Methods</strong>&nbsp;</p>
<p><strong>&gt;Nexplanon:</strong>&nbsp;</p>
<p>&bull;<strong>Form:</strong> A small, single rod underneath the skin that can stay for three years. The small rod must be inserted and removed in a clinic.&nbsp;</p>
<p>&bull;<strong>Effectiveness:</strong> Less than 1 percent probability of pregnancy.&nbsp;
</p>
<p>&bull;<strong>Side Effects:</strong> Can lead to irregular spotting, mood effects and weight gain.&nbsp;
</p>
<p>&bull;<strong>Reversibility:</strong> Immediate return to fertility after removal.&nbsp;
</p>
<p><strong>&gt;Depo-Provera:</strong>&nbsp;</p>
<p>&bull;<strong>Form:</strong> A shot every three months.&nbsp;
</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method ranges between 0.2 and 6 percent depending on perfect or typical use.&nbsp;
</p>
<p>&bull;<strong>Side Effects:</strong> Can lead to irregular spotting, mood effects and weight gain. Bone demineralization effect after five year of use.&nbsp;</p>
<p>&bull;<strong>Reversibility:</strong> Fertility can be delayed after discontinuation.&nbsp;
</p>
<p><strong>Intrauterine Devices (IUD):</strong>&nbsp;</p>
<p><strong>&gt;Copper IUD</strong>&nbsp;</p>
<p>&bull;<strong>Form:</strong> Small, T-shaped copper implant that can last for 10 years. The small implant must be inserted in a clinic.&nbsp;
</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method ranges between 0.5 and 0.8 percent.&nbsp;
</p>
<p>&bull;<strong>Side Effects:</strong> May increase menstrual flow and cramps.
&bull;Other Benefits: Nonhormonal, highly cost effective. Can be used as emergency contraception.&nbsp;</p>
<p>&bull;<strong>Reversibility:</strong> Immediate return to fertility after discontinuation.&nbsp;
</p>
<p><strong>&gt;Mirena/Skyla IUD</strong> (differ in size and hormone content)&nbsp;</p>
<p>&bull;<strong>Form:</strong> Small, T-shaped implant that can last for three to five years. The implant contains small amounts of progesterone that act locally on endometrium and mucous. The small implant must be inserted in a clinic.&nbsp;
</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method ranges between 0.1 and 0.2 percent.&nbsp;
</p>
<p>&bull;<strong>Other Benefits:</strong> Can reduce monthly blood flow and cramps.&nbsp;
</p>
<p>&bull;<strong>Reversibility:</strong> Immediate return to fertility after discontinuation.&nbsp;
</p>
<p><strong>Male/Female Sterilization</strong>&nbsp;</p>
<p>&bull;<strong>Form:</strong> Sterilization is a permanent method of birth control. Sterilization procedures for women are called tubal occlusion. The procedure for men is called vasectomy.&nbsp;
</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method ranges between 1.8 and 3.5 percent.&nbsp;
</p>
<p>&bull;<strong>Risks:</strong> General risk associated with surgical procedures and risk of regret.&nbsp;
</p>
<p>&bull;<strong>Side Effects:</strong> No long-term side effects or hormonal effects.&nbsp;
</p>
<p>&bull;<strong>Reversibility:</strong> Sterilization is a permanent method and should be seen as nonreversible.&nbsp;
</p>
<p><strong>Male/Female Condoms</strong>
(Do not use together!)&nbsp;</p>
<p>&bull;<strong>Forms:</strong> Three different materials: latex, natural membrane (has small pores, less effective for STD prevention), or polyurethane (female). Latex allergy condoms are generally more expensive.&nbsp;
</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method ranges between 2 and 18 percent.&nbsp;
</p>
<p>&bull;<strong>Other Benefits:</strong> Protects against sexual transmitted disease.&nbsp;</p>
<p>&bull;<strong>Availability:</strong> Easy to access over the counter.&nbsp;</p>
<p><strong>Vaginal Barriers with
Spermicides</strong>&nbsp;</p>
<p>&bull;<strong>Forms:</strong> Diaphragm, cervical cap, contraceptive sponge&nbsp;
</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method varies widely between 5 percent and 30 percent.&nbsp;
</p>
<p>&bull;<strong>Side Effects:</strong>
Spermicide can lead to vaginal irritation and therefore a higher chance of HIV infection and higher rates of urinary tract infections.
Withdrawal (Coitus Interruptus)&nbsp;</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method ranges between 5 and 22 percent. This range depends on experience of withdrawal and semen content of preejaculate.&nbsp;
</p>
<p>&bull;<strong>Other Benefits:</strong> No cost, always available, no chemicals, fosters male responsibility and communication.&nbsp;
</p>
<p>&bull;<strong>Side Effects:</strong> May diminish pleasure for both partners.&nbsp;
</p>
<p><strong>Fertility Awareness-Based Methods (FAB)</strong>&nbsp;</p>
<p>&bull;<strong>Effectiveness:</strong> The probability of pregnancy using this method ranges between 0.5 and 24 percent depending on cycle regularity.&nbsp;</p>
<p>&bull;<strong>Other Benefits:</strong> Increased awareness of cyclic function, increased communication between partners, no chemicals.&nbsp;
</p>
<p>The power to &ldquo;choose a pregnancy&rdquo; enables women and their families to better prepare for a pregnancy. For more information about different birth control methods, check out the online resources below.&nbsp;
</p>
<p><strong>Resources:</strong>&nbsp;</p>
<p>&bull;bedsider.org/methods&nbsp;</p>
<p>&bull;cdc.gov&nbsp;</p>
<p>&bull;fertilityfriend.com&nbsp;</p>
<p>&bull;ourbodiesourselves.org&nbsp;</p>
<p>&bull;plannedparenthood.org
</p>Thu, 09 Jul 2015 00:00:00 -0600{7E2ABC3B-406E-46E3-8F36-208EFA9398AD}https://10.40.239.128/blogs/2015/07/holistic-healing/Holistic Healing<strong>UNDERSTANDING THE MIND-BODY CONNECTION</strong>&nbsp;
<p>Our bodies are amazing machines. All of our body&rsquo;s systems, structures and functions work in concert to create the miracle of life while also preventing illness and repairing the body daily.&nbsp;
</p>
<p>In his book, &ldquo;The Body is the Hero,&rdquo; Ronald Glasser, M.D., describes how physicians can assist the body in this constant job of defending and repairing. Medical interventions, however, are relatively small and only work if the body is able to heal itself. The true hero, then, is the patient.&nbsp;
</p>
<p>Ultimately, the patient is the one who must heal. Such healing occurs when three distinct dimensions of health&mdash;mental, physical and emotional&mdash;are addressed and operate together to help a patient think, feel and live.&nbsp;
</p>
<p><strong>The Mind-Body-Spirit Connection</strong>&nbsp;</p>
<p>Understanding this mind, body and spirit connection is vital to living well. How we think, how we make decisions, how we perceive ourselves, events and the future, and our ability to cope with stress for better or worse can all affect physical health.&nbsp;</p>
<p>&nbsp;Physical ailments can spread to become mental and social/emotional disorders. Similarly, illnesses that start mental or social/emotional can spread to and manifest themselves as physical symptoms.&nbsp;</p>
<p>Most patients can quickly recall a time when an event, news or surprise affected them physically. For example, as a patient awaits results from an important test or for an interview, his heart pumps faster, his breath speeds up and his palms sweat in anticipation. When a patient hears tragic news, she may feel like she has been &ldquo;hit by a train.&rdquo;&nbsp;
</p>
<p><strong>Reducing Stress</strong>&nbsp;</p>
<p>Once a patient understands the mind, body, spirit connection, he or she can make choices to improve healing. One of the biggest factors in overall health, for example, is allowing destructive stress to erode mental and physical well-being.&nbsp;
</p>
<p>Psychologist Richard Lazarus described two types of stress in life: eustress and distress 1. Eustress is healthy stress, whereas distress is destructive and negatively affects physical health. Eustress is productive and engages the mind, spirit and body in activities that tap into imagination, education and moral compass. Eustress is vital to good health, helping people to uplift, improve and problem solve.&nbsp;
</p>
<p>Conversely, it is important to identify and diminish exposure to distress to improve overall health. Such an effort includes minimizing violations of conscience (one of the greatest sources of distress), minimizing deviations for planned routines, improving relationships within families and organizations, improving sleep habits, and minimizing risks of external forces dictating life choices. Sometimes it is not possible to minimize external forces causing distress in our lives in the short term, so then we must focus on strategies to cope with distress in the long term. These may include physical illness, financial problems or family discord. Good diet and exercise habits, prayer and meditation, as well as good friend and family support are all helpful in coping with distress.&nbsp;
</p>
<p><strong>Piecing Together Better Health</strong>&nbsp;</p>
<p>Piecing together the bigger picture of health for each patient is like a puzzle, as patient and doctor work together over time to explore patterns that point to physical, mental or emotional causes of symptoms or complaints. Patient and physician cannot focus solely on physical solutions. This approach may possibly mask symptoms, but it may not get at the underlying cause.&nbsp;
</p>
<p>A comprehensive solution for a symptom that may have a mental or social/emotional cause should not stop at alleviating the complaint, but should also try to minimize or eliminate the cause. As patients work along with support from physicians, family and friends to improve lifestyle choices, they can heal in more holistic ways.&nbsp;
</p>
<p>There is no greater satisfaction for a doctor than to work with a patient to identify disease and help them heal. But physicians are not the heroes; they have simply learned to use the mind-body-spirit connection to help their patients become the heroes in their own lives.
</p>Thu, 09 Jul 2015 00:00:00 -0600{C52FAF15-34A7-4EC3-A6A1-4CC5D8D07615}https://10.40.239.128/blogs/2015/07/helping-the-healing-process-with-breast-reconstruction/Helping the Healing Process with Breast ReconstructionDealing with a diagnosis of cancer is always an incredibly traumatic ordeal for the patient and their family. Breast cancer can be even more stressful because of the visible nature of the disease. The combination of having to deal with the emotional stress of being diagnosed with breast cancer on top of the changes in appearance that are associated with the treatment can be difficult to cope with. Whether it is the prospect of temporarily losing all of your hair from chemotherapy, or the loss of a portion or all of one or both breasts, these are often significant symbols of a woman&rsquo;s self-image.&nbsp;
<p>Every year almost 300,000 women face this same situation. Unfortunately studies have shown that more than 75% of women do not know all of the options available to them for reconstruction after mastectomy or lumpectomy. Without all of the information, many women choose to forego reconstruction; or they don&rsquo;t even realize it&rsquo;s an option for them. Frequently, breast cancer survivors are too overwhelmed or embarrassed to ask. Congress passed the Women&rsquo;s Health and Cancer Rights Act in 1998 to ensure that insurance companies that cover mastectomies must also cover breast reconstruction. It does not matter how long ago the mastectomy was done, the woman is still eligible for breast reconstruction.&nbsp;
</p>
<p>I&rsquo;m always saddened when a woman tells me she wished she had known more about breast reconstruction before her mastectomy or lumpectomy, because she would have done things completely differently. Sometimes a sister, daughter, or husband tells me their family member feels deformed, and she thought there was nothing she could do about it because it was so long ago.&nbsp;
</p>
<p>There are numerous options for breast reconstruction. There is no single answer for everyone. A lot depends on the cancer itself of course, but with so many options there is bound to be a right choice for everyone. I typically break down the options into a few categories, but there can always be overlap or hybrid procedures. The simplest, is an external prosthesis you wear in a bra. This can be sized to match the remaining opposite breast, and it doesn&rsquo;t require any surgery. It is very straightforward, but the prosthesis can be heavy or irritating to the skin especially in the summer.&nbsp;
</p>
<p>Surgical options after complete mastectomy are broken down into those using breast implants, or those using your own tissue. When using implants, we typically start with a tissue expander that is placed at the time of mastectomy. This is then slowly filled with saline over a few months until it gets to a size that either matches the opposite breast, or is the desired breast size. The tissue expander is then removed and a softer implant is placed in the same pocket to recreate the breast.&nbsp;
</p>
<p>Breast reconstruction using your own tissue typically involves using the abdominal skin and fat and transferring that up into the breast pocket created by a tissue expander. However, there are multiple other options, and tissue can also be taken from the back or buttocks. The benefit of using your own tissue is that it changes size as you gain or lose weight. It softens and becomes more natural looking over time. Beyond creating a breast we can also recreate nipples using your own skin, and we use tattooing to recreate the color of the areola as well.&nbsp;
</p>
<p>Breast Reconstruction Awareness Day, or BRA Day, was October 15th, 2014. BRA Day, sponsored in large part by the American Society of Plastic Surgery, helps raise awareness for women with breast cancer so they can feel empowered to ask questions about their breast reconstruction options. It can feel selfish or embarrassing to ask about wanting to keep or reconstruct your breast in the midst of dealing with cancer, but it shouldn&rsquo;t. We want to make you feel comfortable, so you can ask all the questions important to you and help you make an informed decision that&rsquo;s right for you. Everyone on the breast cancer team has the same goal &mdash; to treat the cancer and help you feel whole again.</p>Thu, 09 Jul 2015 00:00:00 -0600{216BEF51-2305-4118-B1C9-D5A6EC2C85A2}https://10.40.239.128/blogs/2015/07/answering-questions-about-weight-loss/Answering Questions about Weight Loss<p>Obesity is a growing epidemic in the United States. We hear about this problem on an almost daily basis. Open up an Internet browser and type in &ldquo;obesity epidemic in America,&rdquo; and you get links to numerous articles, graphics, and statistics about this ever-present problem. From my experience as a physician, the worst consequences from this disease are the complications I see in my office every day. These include type 2 diabetes, high blood pressure, heart disease, strokes, obstructive sleep apnea, and many other health conditions(1). I wanted to write this article because I believe weight loss and maintaining a healthy weight are the most beneficial approaches people can use to prevent disease or control the complications of diseases they already have.&nbsp;</p>
<p>Many people understand that losing weight requires exercise and diet. But, the problem that I see with many failed attempts to lose weight is people putting too much importance on exercise while failing to change their diets. They initially lose weight, but can&rsquo;t get to their goals because they haven&rsquo;t changed their eating habits. Exercise is good for many things such as cardiovascular health, endurance, well-being, and staying mentally sharp. But it doesn&rsquo;t burn as many calories as one might think. Diet is the main predictor of weight. One person may be overweight and fit because he or she exercises, whereas another person may be thin and unfit because he or she eats a better diet but doesn&rsquo;t exercise. Most of the calories the average person burns each day are consumed by the normal metabolic processes our bodies go through just to keep us alive.&nbsp;
</p>
<p>Let&rsquo;s challenge the popular adage that states, &ldquo;Losing weight is simply a matter of calories in vs. calories out.&rdquo; Is it really true that if you take in fewer calories than you burn, you will lose weight? For years, I believed it was. I believed it when I graduated from college with a degree in chemistry. All through medical school and for most of my residency I believed that this elementary math would help people lose weight; and I taught it to patients all the time.&nbsp;</p>
<p>Then, in my last year of residency, a faculty member brought up the notion that weight management might not be that simple. Perhaps it also has something to do with the way our bodies process calories.&nbsp;</p>
<p>In processing fats and proteins your body secretes bile and enzymes into your digestive system to break apart these foods and help absorb them. However, once you absorb the fats and proteins, your body decides what to do with these nutrients by also reacting to your carbohydrate consumption. Eating complex carbohydrates and sugars causes your body to release insulin to bring your blood sugar level down. Insulin is a storage hormone. In addition to regulating blood sugar, it also causes your cells to store fat and take up amino acids to produce proteins.&nbsp;</p>
<p>So if you eat three high-carbohydrate meals and two or three high-carbohydrate snacks each day, then your body is in a constant state of trying to store calories instead of burn them.&nbsp;</p>
<p>This principle was shown in an article in the New England Journal of Medicine in May of 2003. It illustrated that severely obese patients, with a body mass index greater than thirty-five percent, lost more weight on a low carb diet than a low-fat, low-calorie diet (2). This changed my perspective. It&rsquo;s not just the number of calories we take in, but also what type of calories we eat that determine our weight.&nbsp;</p>
<p>Weight Loss Recommendations:&nbsp;</p>
<p>1. Diet and exercise are both important in losing weight. Diet is the biggest factor affecting weight.&nbsp;</p>
<p>2. At every meal, make starches &ndash; bread, rice, potatoes, pasta, cereal, etc. - Only one-quarter of your plate. Fill the other three-quarters with lean protein, non-starchy vegetables, and a lesser portion of fruit.&nbsp;</p>
<p>3. Choose small, balanced snacks that mix some carbohydrate (fruit, dairy, grains) with a lean protein or non-starchy vegetable.&nbsp;</p>
<p>4. A diet needs to be a lifestyle change, not something you do for three to six months. If your diet is not a lifestyle change you will become a yo-yo dieter.&nbsp;</p>
<p>5. Your diet will fail if you try to cut out foods you love. Instead, eat everything in moderation, and make the food you love a part of your portioned plate.&nbsp;</p>
<p>6. Don&rsquo;t drink your calories. If you are thirsty, drink water.</p>Thu, 09 Jul 2015 00:00:00 -0600{1AEA97CB-D037-442B-83EF-866992FF6E49}https://10.40.239.128/blogs/2015/07/abdominal-aortic-aneurysm/Abdominal Aortic AneurysmNew Treatment Speeds Recovery&nbsp;
<p>An Abdominal Aortic Aneurysm, or AAA, is an abnormal enlargement or bulge in the abdominal section of the aorta, the body&rsquo;s largest artery that carries blood from the heart to all parts of the body. An aneurysm can cause the aorta to grow to several times its natural size, weakening it, and possibly causing it to rupture.&nbsp;
</p>
<p>Until the last decade, invasive surgery was the primary recourse to prevent abdominal aortic aneurysms from becoming deadly. A less-invasive technique called endovascular stent graft repair, however, is changing the treatment protocol and resulting in less blood loss, fewer days of hospitalization and a potentially faster recovery time for patients with AAA.&nbsp;
</p>
<p><strong>Open Surgery</strong>&nbsp;</p>
<p>In conventional or open surgery, the surgeon reaches the aneurysm through a large incision in the abdomen. The weakened section of the vessel, where the aneurysm has formed, is usually surgically removed and replaced with a synthetic material. Open surgery is usually performed under general anesthesia and takes about four to five hours to complete. Repairing the aneurysm surgically is complex and requires an experienced vascular surgical team. After surgery, the patient usually stays in the Intensive Care Unit a day or two, and then another five to seven days in the hospital. The full recovery time may be about three to six months.</p>
<p><strong>Endovascular Stent Graft Repair</strong></p>
<p>Endovascular Abdominal Stent-Grafting was invented in the early 1990s as a less-invasive endovascular method of repair of an abdominal aortic aneurysm and has rapidly expanded as the treatment of choice due to its clinical benefits.&nbsp;</p>
<p>The procedure involves two skin punctures or small incisions in the groin area, where the stent-graft is inserted into the femoral artery through a catheter to reline the abdominal aorta. The stent graft is a woven fabric tube supported by a tubular metal scaffold. The device is placed inside the diseased abdominal aorta without a major surgical incision and seals off the aneurysm by fitting inside the diseased part of the aorta, making a new path for blood to flow.&nbsp;
</p>
<p>The procedure can be done under general, regional or local anesthesia and typically takes one to two hours to complete. The hospital stay is generally one to two days, and patients can expect to resume normal activities in one to two weeks after the procedure. Regular follow-up is needed to evaluate and ensure the success of the stent graft treatment over time. The endovascular treatment of AAA has become the treatment of choice at McKay-Dee Hospital, where surgeons have been performing this procedure successfully for the past 10 years.&nbsp;</p>
<p><strong>Risks and Symptoms for Aortic Aneurysm</strong>&nbsp;
</p>
<p>Abdominal aortic aneurysms are most often caused by a weakening in the aortic wall, resulting from vascular disease, traumatic injury or a genetic defect. In addition, as we age, high blood pressure can cause the aorta to bulge out, thin and weaken, resulting in an aneurysm. Men older than 60, smokers, and those with a family history are most at risk.&nbsp;
</p>
<p>The risk of an abdominal aortic aneurysm increases for patients who:&nbsp;</p>
<p>&bull; Smoke.&nbsp;</p>
<p>&bull; Have high blood pressure.&nbsp;</p>
<p>&bull; Have high cholesterol.
&bull; Are overweight.&nbsp;</p>
<p>&bull; Have a family history of aneurysms, cardiovascular or peripheral vascular disease (narrowing of the blood vessels).&nbsp;
</p>
<p>Abdominal aortic aneurysms may go unnoticed initially because patients may not feel any symptoms. Frequently, an AAA is discovered incidentally on an imaging study such as an abdominal ultrasound or CT scan of the abdomen.&nbsp;
</p>
<p><strong>When symptoms are experienced, the most common are:</strong>&nbsp;</p>
<p>&bull; Pain in the abdomen, chest or lower back, possibly spreading to the groin, buttocks or legs. The pain may be deep, aching, gnawing and/or throbbing, and may last for hours or days. It is generally not affected by movement.&nbsp;</p>
<p>&bull; A pulsating sensation in the abdomen.&nbsp;</p>
<p>&bull; Back pain, if the aneurysm is pressing on the spine.&nbsp;</p>
<p>&bull; A &ldquo;cold foot&rdquo; or a black or blue painful toe if an AAA produces a blood clot that breaks off and blocks blood flow to the legs or feet.&nbsp;</p>
<p>&bull; Fever or weight loss, if the AAA is an inflamed/infected aortic aneurysm.</p>Thu, 09 Jul 2015 00:00:00 -0600{12161090-04DF-4E18-86B8-AB472CAE4172}https://10.40.239.128/blogs/2015/07/a-pinch-of-salt-or-less/A Pinch of Salt or LessSalt &ndash; and more particularly the sodium component of salt &ndash; has come under increasing fire of late for its role in exacerbating certain health conditions. According to the Centers for Disease Control and Prevention (CDC), &ldquo;about 90% of Americans eat more sodium than is recommended for a healthy diet. Too much sodium increases a person&rsquo;s risk for high blood pressure. High blood pressure often leads to heart disease and stroke.&rdquo;&nbsp;
<p><strong>How much sodium do I need?</strong>&nbsp;</p>
<p>Americans typically consume more than 3,000 mg of sodium per day. The U.S. Dietary Guidelines recommend that Americans limit their sodium intake to 2,300 mg per day.&nbsp;
</p>
<p><strong>Adults who should be especially cautious with sodium intake, include:</strong>&nbsp;</p>
<p>&bull; Those 50 years of age or older&nbsp;</p>
<p>&bull; African-Americans&nbsp;</p>
<p>&bull; Those with a history of high blood pressure, diabetes, kidney disease, heart disease, or fluid retention&nbsp;
</p>
<p>To give you some perspective, <strong>one teaspoon of salt contains just over 2,300 mg of sodium!</strong> Even adding a pinch of salt, roughly 1/8 teaspoon, to a dish adds about 300 mg of sodium.&nbsp;
</p>
<p><strong>What foods are high in sodium?</strong>&nbsp;</p>
<p>According to the CDC, 44% of the salt we consume comes from ten specific foods:&nbsp;</p>
<p>&bull; Breads and rolls&nbsp;</p>
<p>&bull; Cold cuts and cured meats such as deli or packaged ham, or turkey&nbsp;</p>
<p>&bull; Pizza&nbsp;</p>
<p>&bull; Fresh and processed poultry&nbsp;</p>
<p>&bull; Soups&nbsp;</p>
<p>&bull; Sandwiches such as cheeseburgers&nbsp;</p>
<p>&bull; Cheese&nbsp;</p>
<p>&bull; Pasta dishes&nbsp;</p>
<p>&bull; Meat-mixed dishes such as meatloaf with tomato sauce&nbsp;</p>
<p>&bull; Snacks such as chips, pretzels, and popcorn</p>
<p>Too much sodium increases a person&rsquo;s risk for high blood pressure. High blood pressure often leads to heart disease and stroke. &nbsp;</p>
<p>Manufacturer-prepared foods and restaurant-prepared dishes are significantly higher in salt than home prepared foods, generally speaking. Some foods can be surprising in their salt content. For instance, a &ldquo;healthy&rdquo; sandwich made of two slices of whole wheat bread, deli turkey, cheese, lettuce, tomato, onion, mustard, and light mayo provides a total of 2,100 mg of sodium &ndash; an entire day&rsquo;s worth even without the salty potato chips on the side!&nbsp;
</p>
<p>You can find more tips for low-sodium eating at www.intermountainhealthcare.org. My favorite online resources for low-sodium recipes include:
www.heart.org; www.sodiumgirl.com; and www.lowsodiumcooking.com.&nbsp;
</p>
<p>Also, keep in mind that your taste preferences for salt will change with time. While you may miss the saltiness of a dish initially, continuing to cook and eat low-sodium foods will allow you to start to recognize the other wonderful flavor nuances in foods. Eventually, you won&rsquo;t even miss that pinch of salt!
Americans typically consume more than 3,000 mg of sodium per day. &nbsp;</p>
<p><strong>How do I decrease my salt intake?</strong>&nbsp;</p>
<p>Decreasing your salt intake doesn&rsquo;t have to be hard. Here are some easy tips to get started:&nbsp;</p>
<p>&bull; When grocery shopping, purchase &ldquo;No Salt Added&rdquo; or &ldquo;Low Sodium&rdquo; varieties of foods.&nbsp;</p>
<p>&bull; Cook at home more often. Making your own pasta sauce, for instance, can really be quite simple and it tastes great!&nbsp;</p>
<p>&bull; Add flavor without adding salt &ndash; experiment with salt-free herbs, spices, vinegars, and extracts.&nbsp;</p>
<p>&bull; Read food labels to become more familiar with the sodium content in the foods you regularly eat. Limit foods with more than 200 mg per serving.&nbsp;</p>
<p>&bull; Watch the ingredient list for any ingredient containing the words sodium, baking soda, or baking powder.&nbsp;</p>
<p>&bull; Eat more fresh fruits and vegetables.&nbsp;</p>
<p>&bull; Skip the salt in recipes whenever possible.&nbsp;</p>
<p>&bull; Don&rsquo;t add extra salt at the dinner table. Choose to add pepper instead.&nbsp;</p>
<p>&bull; Ask restaurants to not add salt when preparing your order.</p>Thu, 09 Jul 2015 00:00:00 -0600{660B2B53-833A-4BC8-8972-F1E95925DD98}https://10.40.239.128/blogs/2015/07/three-wrong-ways-to-run-and-their-solutions/Three wrong ways to run and their solutions&ldquo;One practice runners fall into is the tendency to &lsquo;heel strike&rsquo; or land too severely on the heels of their feet during a run,&rdquo; said Chad Allred, physical therapist at American Fork Hospital. &ldquo;If your stride is too far out when you heel strike, the heels then act like a brake, and the momentum is transferred up through the joints rather than the muscles, causing potential joint injuries in the legs.&rdquo;&nbsp;<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
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Allred suggested runners&rsquo; feet should be more under their center of gravity when running so their leg muscles take the force rather than the joints. He advised shortening stride length to land with a slight heel-foot strike, mid-foot or even a subtle forefoot strike, keeping away from a full-force land on the heels.<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
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Another common problem to look out for is trunk rotation, or how much the upper body is twisting from side to side. Excessive trunk rotation can negatively affect speed and efficiency during a run.&nbsp;<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
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Allred said one strategy to address this is to pay attention to changes in speed, which may give runners queues to think about form and try to correct it. He recommended trying a phone app to help such as TempoRun, which allows you to keep track of your pace, or AudioStep, which measures your cadence (how often your feet touch the ground) while running.&nbsp;<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
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A third common mistake for runners is under-training or failing to prepare their bodies for the extent of the race. &ldquo;One of the biggest mistakes in preparing for a long run is not training adequately for the distance of it,&rdquo; Allred said. &ldquo;If you&rsquo;re preparing for a half-marathon (13.1 miles), and train by running only six or seven miles, you set yourself up for injury because the race is significantly more mileage than your training distance.&rdquo;&nbsp;<br style="margin: 0px; padding: 0px; outline: 0px; border: 0px; color: #666666; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 13.6000003814697px; line-height: 20.4000015258789px; background-color: #ffffff;" />
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The physical therapist said it&rsquo;s also critical to prepare for the terrain of a race. If the course includes downhill terrain, the participants need to have some of that in their training.Thu, 09 Jul 2015 00:00:00 -0600{C79B9B09-D679-49A7-A99E-A5F4EEBDA183}https://10.40.239.128/blogs/2015/07/heat-kills-three-tips-to-help-you-avoid-heat-related-illnesses-this-summer/Heat kills: Three tips to help you avoid heat-related illnesses this summer&ldquo;The elderly and the sick are most susceptible to heat-related illnesses, but anyone who&rsquo;s out and about when it&rsquo;s hot is at risk, especially those who exercise in the heat&rdquo; said Colin Grissom, MD, a critical care physician and wilderness medicine expert at Intermountain Medical Center.<br />
<br />
Here are three important things Dr. Grissom says you can do to avoid heat-related illness this summer:<br />
<ol>
<li><strong>Avoid exerting yourself during the hottest part of the day.</strong> If you want to do some yard work, go running, or take a hike, do it in the morning or evening when temperatures are lower.</li>
<li><strong>Stay hydrated.</strong> Drink plenty of water. If you&rsquo;re thirsty at all, it&rsquo;s time to start drinking. If you&rsquo;ll be out working or exercising for more than two hours, you&rsquo;ll also need some electrolytes, either from a liquid that contains electrolytes &mdash; such as Gatorade &mdash; or from salty snacks.<br />
<em>A word of caution:</em> Dr. Grissom warns that drinking too much water during prolonged periods of exercise in the heat can lead to a dangerous and sometimes fatal condition called hyponatremia. Endurance athletes who are exercising for over several hours in the heat are at the greatest risk. &ldquo;Just don&rsquo;t force yourself to drink a bunch of water when you&rsquo;re not thirsty, and make sure you&rsquo;re getting plenty of electrolytes,&rdquo; Dr. Grissom said. &ldquo;For periods of exercise lasting less than two hours, water is an adequate fluid for hydration.&rdquo;</li>
<li><strong>Protect yourself from the sun.</strong> Wear sunscreen, lip balm, a hat, and loose-fitting clothing anytime you&rsquo;ll be out in the sun. &ldquo;As you get higher up in the mountains you&rsquo;ll be more vulnerable to the sun,&rdquo; warns Dr. Grissom. &ldquo;I recommend you use at least SPF 30 sunscreen applied frequently if you&rsquo;ll be out in the wilderness.&rdquo;</li>
</ol>
<strong>What should you do if you have heat stroke or heat exhaustion?</strong><br />
Signs of heat exhaustion include intense thirst, weakness, discomfort, and dizziness. If you experience any of these symptoms, rest in the shade or a cool place and drink cool liquids. It can also help to sit by a fan or immerse yourself in cool water.<br />
<br />
Heat exhaustion can lead to heat stroke, which is potentially fatal. Symptoms include confusion and altered mental status, seizures, and loss of consciousness.<br />
<br />
&ldquo;If a person has heat stroke, we need to bring their temperature down right away or they could die,&rdquo; Dr. Grissom said. &ldquo;Someone who has symptoms of heat exhaustion and who develops an altered mental status may be succumbing to heat stroke and need to get out of the heat and seek medical attention immediately. Applying ice packs to the groin and armpits can help during transport to an emergency department.&rdquo;Wed, 08 Jul 2015 00:00:00 -0600{0C783014-A671-442E-AD32-5BDCC0F4BE21}https://10.40.239.128/blogs/2015/07/surgery-saves-teen-from-embarrassment-of-sweaty-palms/Surgery saves teen from embarrassment of sweaty palms<p>Hailey Bennett&rsquo;s hands were sweating nervously the day she had surgery in December 2014. Though not an unusual reaction, her sweaty palms were actually the reason behind the operation.</p>
<p>As long as she could remember, the 14-year-old daughter of Matt and Jeanette Bennett lived with the inconvenience of extremely sweaty hands. Known as hyperhidrosis, her condition caused significant challenges in her everyday life.</p>
<p>&ldquo;I was always thinking about my sweaty hands,&rdquo; said Bennett. &ldquo;Though some people probably didn&rsquo;t notice, I couldn&rsquo;t help but make a big deal of it in my mind. When going to dances and different social events, I didn&rsquo;t want to touch or dance with anyone. At school, I didn&rsquo;t want anyone to know about my sweaty hands, so I avoided touching people.&rdquo;</p>
<p>The disorder, which affects 1 percent of the nation&rsquo;s population, also interfered with basic things such as playing the piano, eating food, shaking hands with people and even putting on makeup, which had to be done using the back of her hand rather than her palms. </p>
<p>With the help of her parents, Bennett tried many therapeutic options including using baking soda, antiperspirant prescriptions and even electric treatment for her hands &mdash; all of which were ineffective. Finally, her parents found out about a procedure known as surgical sympathectomy that solves the problem of sweaty palms. </p>
<p>&ldquo;It&rsquo;s not a fancy operation. It&rsquo;s minimally invasive and the condition is completely treatable,&rdquo; said John Mitchell, MD, who performed Bennett&rsquo;s surgery at Utah Valley Regional Medical Center. &ldquo;For this procedure, it&rsquo;s not so much a matter of whether patients are cured or not, but how satisfied they are with the result of the surgery.&rdquo;</p>
<div style="position:relative; display:block; height:0; overflow:hidden; padding-bottom:56.25%;"><iframe src="//www.youtube.com/embed/odSClDk0I1k" style="position:absolute; top:0; bottom:0; left:0; width:100%; height:100%; border:none;" frameborder="0" allowfullscreen=""></iframe></div>
<p>The success of Bennett&rsquo;s surgery was evident right away. &ldquo;Right when I woke up after the surgery, I saw automatic results. I couldn&rsquo;t stop rubbing my hands together in amazement,&rdquo; said the young teen.</p>
Her parents have seen a difference as well. &ldquo;We felt this surgery was a good investment in Hailey&rsquo;s future happiness and her social life. Now that this limiting factor is taken away, she can look forward to an exciting life ahead of her,&rdquo; said her mom, Jeanette.Wed, 08 Jul 2015 00:00:00 -0600{B499EC83-FC34-4F7D-931B-FAEA7616ECB7}https://10.40.239.128/blogs/2015/07/dangers-of-the-sunburn-art/Dangers of Sunburn Art<p>First it was the cinnamon challenge, then Kylie Jenner lips, and now the latest photo trend on social media channels is sunburn art. What is <a href="http://time.com/3944708/sunburn-art/" target="_blank">sunburn art</a>, you ask? The idea is to create intricate designs on the body (similar to a tattoo) with sunscreen template cutouts, and then venturing out in the sun for an intense sunburn. </p>
<p>Dr. Marc Sanders, dermatologist at the Intermountain Memorial Clinic, urges people to consider the seriousness of sunburns, and to demonstrate their artistic and creative talent in a way that won&rsquo;t cause skin cancer. &nbsp;</p>
<p>&ldquo;People must realize how risky this kind of sun exposure is,&rdquo; Dr. Sanders said.&nbsp;&ldquo;The risk for melanoma, the most dangerous kind of skin cancer, doubles in people who have had more than five sunburns, particularly when they are younger.&rdquo;&nbsp;</p>
<p>Intermittent, intense sun exposure causing burns is particularly risky for melanoma, but may increase the risk of other skin cancers also. <a href="http://fox13now.com/2015/07/02/dangerous-new-summer-trend-increasing-chances-of-cancer-by-50-percent/">Some experts indicate</a> these intense sun exposure activities can increases chances of melanoma by 50 percent. Skin cancer rates are increasing dramatically because of increased exposure to ultraviolet radiation and these trends are not bending the curve.</p>
<p style="line-height: 13.5pt; background: white none repeat scroll 0% 0%;">If you think you might have signs of melanoma start with checking out a mole or other mark on your skin. Your health care provider will examine your skin with the ABCDE rules in mind. This means looking at:</p>
<ul>
<li><strong>A</strong>symmetry. One half of the mole does not match the other half.</li>
<li><strong>B</strong>order irregularity. The edges of the mole are ragged or irregular.</li>
<li><strong>C</strong>olor. The mole has different colors in it. It may be tan, brown, black, red, or other colors. Or it may have areas that appear to have lost color.</li>
<li><strong>D</strong>iameter. The mole is bigger than 6 millimeters across, about the size of a pencil eraser. But some melanomas can be smaller.</li>
<li><strong>E</strong>volving. A mole changes in size, shape, or color.</li>
</ul>
<p>Your health care provider will ask you about the mole. Tell him or her:</p>
<ul>
<li>When you first noticed it</li>
<li>If it hurts or itches</li>
<li>If it oozes fluid or bleeds, or gets crusty</li>
<li>If it&rsquo;s changed in size, color, or shape</li>
</ul>
<p>&nbsp;</p>
<p>&nbsp;</p>Tue, 07 Jul 2015 00:00:00 -0600